What is hepatitis A?

Hepatitis A is one of several types of hepatitis that results in liver disease. It is caused by the hepatitis A virus.

What are the symptoms of hepatitis A?

Symptoms usually begin with fever, loss of appetite, nausea, abdominal discomfort and tiredness. These symptoms are generally followed in a few days by jaundice (a temporary yellowing of the skin and eyes), dark colored urine, and pale stools. Infected people can have symptoms that range from mild to severe, or can be infected without noticeable symptoms. Young children frequently have mild illness, or no illness at all. Recovery is usually complete.

Who gets hepatitis A?

Anyone who has never had hepatitis A can get it if exposed to the virus. In the United States, the virus is present in most communities and can cause isolated cases of disease or widespread epidemics.

Especially at risk are:

People who live in the same household or have sexual contact with someone who has hepatitis A.

Children and employees in child care centers (especially centers that have children in diapers) where a child or employee has hepatitis A.

Travelers to developing countries where hepatitis A is common and where clean water and proper sewage disposal are not available.

How is hepatitis A spread?

When someone has hepatitis A, the virus is present in the stool. The virus can be spread from person to person by putting something in the mouth that is contaminated with infected stool. For this reason, the virus is more easily spread under poor sanitary conditions, and when good handwashing is not observed. People can also get hepatitis A by consuming contaminated water or ice, raw shellfish harvested from water contaminated by sewage, and uncooked fruits, vegetables or other foods contaminated during handling.

When do symptoms appear?

It can take 15 to 50 days from the time a person is exposed until the first symptoms appear. On average, the symptoms first occur about 30 days after exposure.

How long is an infected person able to spread hepatitis A?

People are most infectious in the two weeks before their jaundice appears and they remain infectious during the eight days after jaundice starts. At that point, even if the individual is still sick, the virus cannot be spread to others.

How is hepatitis A diagnosed?

A blood test is available to diagnose hepatitis A.

How is hepatitis A prevented?

Since many disease-causing germs, including the hepatitis A virus, are passed in the stool, it is always important to practice good hygiene. That includes thorough handwashing after using the bathroom, before preparing food, and after changing diapers or helping others with toileting.

Hepatitis A vaccine was licensed for use in the U.S. in 1995. It is recommended for specific groups who are more likely to be exposed to hepatitis A infection. Individuals should check with their health care providers to see if they should get this vaccine.

What is done if a person is exposed to hepatitis A?

People who may have been exposed to hepatitis A are offered either a hepatitis A vaccine or a dose of immunoglobulin (IG) to lower the risk of infection. These must be given within 14 days of most recent close contact with an infected person. Guidelines for selecting hepatitis A vaccine vs. a dose of IG are based on age and health factors:

For people between ages one and 40, a single dose of hepatitis A vaccine will minimize their chances of becoming ill.

For those who cannot receive the vaccine (babies under 12 months and people who are immunocompromised) a single dose of IG should be given.

For people over age 40, and those with chronic liver disease, IG is preferred over hepatitis A vaccine to lower the risk of infection

To prevent future infection, hepatitis A vaccine can be offered to those who received IG if they do not have a medical condition that makes vaccination unsafe.

What precautions should be taken when diagnosed with hepatitis A?

Stay home during the infectious period, that is, until eight days after the start of symptoms. Use strict personal hygiene practices. Do not prepare food for others during that time. If you must prepare food for family members, use careful handwashing. Notify all contacts (household guests, overnight guests, sexual partners and day care contacts) so they can contact their health care providers and arrange for IG if necessary.